糖尿病与白内障超声乳化术中虹膜松弛综合征的关联

Relation of diabetes mellit us with intraoperative floppy-iris syndrome during phacoemulsification

目的:探讨糖尿病与白内障超声乳化术中虹膜松弛综合征(intraoperative floppy iris syndrome,IFIS)的关联。方法:选取白内障超声乳化术中IFIS患者30例52眼作为IFIS组,术中未出现IFIS患者60例108眼作为对照组;收集两组患者基线资料,Logistic回归分析白内障超声乳化术中IFIS的危险因素,ROC曲线分析相关指标预测IFIS的价值。结果:Logistic回归分析显示糖尿病史[Exp(B)=1.514,95%CI:0.842～5.281]、空腹血糖(FPG)[Exp(B)=1.958,95%CI:1.163～11.728]、糖化血红蛋白(HbA1c)[Exp(B)=2.044,95%CI:1.409～14.620]及α-1受体拮抗剂应用史[Exp(B)=1.791,95%CI:1.128～10.752]是白内障超声乳化术中IFIS的独立危险因素;FPG预测白内障超声乳化术中IFIS的AUC为0.645,Hb A1c预测IFIS的AUC为0.767;FPG≥7.0mmol/L,预测白内障超声乳化术中IFIS的敏感度为0.849,特异度为0.241;HbA1c>9.0%预测白内障超声乳化术中IFIS的敏感度为0.733,特异度为0.600。结论:白内障超声乳化术中IFIS发生与糖尿病史、FPG、Hb A1c及α-1受体拮抗剂应用史有关,术前HbA1c测定对术中IFIS有较好的预测价值。

AIM:To explore relation of diabetes mellitus with intraoperative floppy-iris syndrome(IFIS)during phacoemulsification.METHODS:Thirty patients with IFIS who underwent phacoemulsification were enrolled as IFIS group.The patients in whom IFIS did not appear were as the control group.The baseline data of two groups were collected.The risk factors of IFIS in phacoemulsification were analyzed by Logistic regression analysis.The forecasting indicators of IFIS were analyzed by ROC curve.RESULTS:Logistic regression analysis showed that diabetes(Exp(B)=1.514,95%CI:0.842-5.281\],fast plasma glucose(FPG)\[Exp(B)=1.958,95%CI:1.163-11.728\],HbA1c\[Exp(B)=2.044,95%CI:1.409-14.620\]and the history of application ofα-1 receptor antagonists\[Exp(B)=1.791,95%CI:1.128-10.752\]were independent risk factors for IFIS in cataract phacoemulsification.The AUC of FPG predicting IFIS was 0.645.And The AUC of HbA1c predicting IFIS was 0.767.The sensitivity of FPG≥7.0mmol/L predicting IFIS was 0.849,the specificity was 0.241.The sensitivity HbA1c>9.0%predicticting IFIS,was 0.733,specificity was 0.600.CONCLUSION:The occurrence of IFIS in phacoemulsification is related to the history of of diabetes,FPG,HbA1c and application ofα-1 receptor antagonist.The preoperative measure HbA1c has a good predictive value of IFIS.